For what we need to do in mental health research, the DSM approach is not appropriate. Even if it is still the best way to diagnose disorders and deliver treatment and knit the mental health care system together, it must begin to be supplanted by a new science-based framework.

The flat out rejection of DSM-5 by National Institute of Mental Health is a sad moment for mental health and an unsafe one for our patients. The APA and NIMH are both letting us down, failing to be safe custodians for the mental health needs of our country.

Personalized psychiatric diagnosis has great promise and may be one of the few ways out of the current impasse -- the constant flow of group mean studies giving non-replicated or barely-significant differences.

Unfortunately, DSM 5 will make the current problems with mislabeling much worse. Its new proposals (with the possible exception of autism) all cast a wider diagnostic net that will lead to much looser and less accurate diagnosis.

Will the unfavorable press result in a more favorable DSM 5 outcome? We must hope so, because so few other corrective options are available. DSM 5 remains steadfast and rigid in its support of really bad proposals with extremely dangerous unintended public health consequences.

Preventive psychiatry may someday be of significant service in reducing the burden of human suffering -- but only if it can be done really well. And the sad truth is that we don't yet have the necessary tools.